The vaccine lottery is working. Experts explain why

Four states have now introduced a million-dollar lottery for those receiving the COVID-19 vaccine. A behavioral economist explains why the dream of the big prize works. (Photo: Getty Images)

approximately 50 percent To this week, Americans have been at least partially vaccinated, a major milestone that, not too long ago, felt out of reach. But with some states still far behind the majority-vaccinated population, many have turned into a dependably attractive proposition: financial incentives.

Ohio was the first state to try this approach Wax-a-million program, A campaign that provides five $ 1 million awards to vaccinated adults in the state and four full-ride scholarships for 12 to 17-year-olds in Ohio state schools. The program was an instant success, giving a 28 percent increase In vaccination over the weekend following the announcement. in totality, 2.7 million Ohioans Has now signed up for the state’s vaccine lottery, which is about 23 percent of its entire population.

As the success of Ohio’s program became clear, more states followed suit. Oregon launched Similar million-dollar lottery Last week – including free tuition to state colleges – did the same. New York, Colorado And Maryland. Main started To award Such as free fishing licenses and LL Bean gift cards, while New Jersey began offering free beer. Even the central government has joined it. Admirable state To be creative with your vaccination campaigns.

On the national COVID-19 response, White House senior adviser Andy Slavitt said, “The data we’ve seen appear to be working.” said on Tuesday. “I think the reason they work is because a large number of people who have not been vaccinated yet are not really opposed to vaccination; they are not giving it too much priority … and So things that draw attention to it, such as the lotteries in the states you’ve mentioned, are surprisingly not very effective, and that’s why we’re excited. “

So what is it about the incentives that encourage people to get vaccinated – and does any kind of reward work? Dr david ashoExecutive Director of Penn Medicine Center for Health Care Innovation, well versed in the world of encouragement. Asch is an expert in the field known as “behavioral economics” – inter alia – how various psychological, cultural and social factors influence decision making.

Ash explains how new the vaccine lottery and the prize seem, despite the fact that incentives are not new in the healthcare world. “Look at your health insurance plan,” Ash tells Yahoo Life. “These are all co-pays and deductibles and out-of-pocket maximums and in and out-of-network things, each one of them is a financial incentive directed by you, the health insurance plan member receives to direct you Healthcare in a certain way. “

But not all vaccine awards are created equal. “If anyone claims that we are going to use incentives to promote vaccination, my question is what kind?” Says asha. Offering things like free beer or a $ 100 savings bond (which West Virginia things Doing now) Can have a lot of “transactions” to make a big impact, he says. “They can be effective, but they are unlikely to have a major impact on vaccination rates.”

On the other hand, the lottery enters people’s emotional side and provides an “exciting” opportunity. “Let’s face it, buying lottery tickets is a fairly bad idea in the form of investment returns – only money on the dollar,” Ash says. “But a lottery gives a chance to win a big prize and people are more likely to focus on a big prize than a small chance of winning that prize.”

There is a way to see what a psychologist calls “Unrealistic optimism, “But another interpretation is that as humans, we cannot fully understand how unlikely it is that we will win. It is a psychological phenomenon that we focus more on the rewards and the implications of the small Has a hard time understanding it. Probabilities, “says Aash. “A typical person does not understand the difference between one in 100 opportunities and one in 10,000 opportunities. They both seem small, but one is a Hundred Many times larger than the other. You might think it would make a difference, but it is not. We just can’t understand it. “

Robert Williams, A clinical psychologist at the University of Lethbridge, who has studied the psychology of the lottery, explained it in a similar way. To science magazine Nautilus. “People just aren’t able to understand 1 in 175 million,” Williams said. “This is beyond our experience — we have nothing in our evolutionary history that prepares or primates us, there is no intellectual architecture to understand and understand the remoteness of those obstacles.”

Aash agrees. “It’s not our fault, we’re just wired that way,” he says. “The lottery takes advantage of our focus on the prize; it gives them some emotional appeal – that emotional punch.” The good news for states willing to spend millions is that there should not necessarily be a traditional lottery to have the same effect. “New Jersey is giving passes to state parks and also a chance to have dinner with the governor and his wife. It’s really cool. I want to have dinner with the governor and his wife, so it’s a There is a lottery experience, ”says Aash. “If I really want to go to the state park, I can buy a pass for the state park. It doesn’t have the emotional appeal.”

In terms of who these lotteries can have a positive effect on, Ash says it is more likely to be someone who relied on the science of the vaccine, but simply did not plan to get one. Adding money to the equation can actually make people who are concerned about its safety become more distrustful of the vaccine and the motives behind it.

“If you have too much idea that the vaccine is bad, you would interpret most of the information as confirming that view. We have what is called confirmation bias, which means that not only do we look for information that is Confirms our prior beliefs, but we interpret the information so that it confirms our prior beliefs, ”says Aash. “So someone who was really keen to get vaccinated would look at $ 100 and say, ‘That’s great.’ And someone who is really concerned about the safety of vaccines will see the same $ 100 and say, ‘Well, they certainly wouldn’t offer $ 100 if it was safe.

Overall, Ash says he does not oppose any incentives regarding vaccinations, he simply hopes that states will consider their effectiveness before launching them. “Our goal is to increase vaccination rates, so we should not rely on any one strategy to do this,” he says. “Each of these things is part of a campaign where some strategies work better with some people and with others.”

But in his opinion, the incentives that follow our imaginations will always work best. “The rewards that allow you to dream, harness our passion,” he says. “I don’t think one Krispy Kreme donut in a day, that doesn’t satisfy any of my passions – no disrespect to Krispy Kreme.”

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